Attacks Of Renal Colic Research Articles

Efficacy of sexual stimulation in the treatment of distal ureteral stones: A meta-analysis

IntroductionThis study aimed to compare the clinical efficacy of sexual stimulation with that of placebo in the treatment of distal ureteral stones. MethodsWe searched PubMed, Web of Science, Cochrane Library, and Google Scholar from January 1, 2000 to December 31, 2022 for studies comparing the efficacy of sexual stimulus with that of placebo for the treatment of distal ureteral stones. RevMan 5.3 software was used to pool the data. The study protocol was registered on PROSPERO (Registration Number: CRD42023432408). ResultsA total of six randomized controlled trials comprising 535 cases of distal ureteral stones were included in this study. Among these, 273 cases were associated with sexual intercourse or masturbation 3–4 times a week, while 262 cases only received symptomatic treatment. The pooled results showed that the 2-week [risk ratios (RR) = 1.77, 95 % confidence interval (CI): 1.34, 2.33] and 4-week [RR = 1.48, 95 % CI: 1.29, 1.69] ureteral stone expulsion rates of the sexually stimulated group were significantly higher than those of the placebo group (ps < 0.01). Additionally, sexual stimulation was associated with a shorter ureteral stone expulsion time [weighted mean differences (WMD) = −3.74, 95 % CI: −6.27, −1.22, p < 0.01] and a decreased prevalence of renal colic attacks [WMD = −0.61, 95 % CI: −1.01, −0.22, p < 0.01] compared with those of the placebo group. ConclusionAppropriate sexual stimulation can enhance the spontaneous expulsion of distal ureteral stones in patients presenting with tolerable pain.

Complementary and Alternative Medicine Usage and Quality of Life in Patients With Renal Colic Attack.

Decreased quality of life is observed in individuals who fear surgery or experience severe symptoms due to urinary system stone disease (USSD). As a result, some patients seek complementary and alternative medicine (CAM) methods. This research evaluates preoperative CAM usage and its effects on quality of life for patients who experience renal colic (RC) due to USSD. The research was conducted between April 2020 and 2021 in the application and research center of a university. One hundred ten patients who were scheduled to have surgery due to USSD were included in the study. The data were collected using the "personal information form," "Use of CAM Methods of Individuals," and 36-item Short-Form Health Survey (SF-36) forms. Of research participants, 47.3% reported using at least one CAM method. The most common methods were exercise combined with phytotherapy (16.4%) and dietary supplements (15.5%). The proportion of participants who reported using 1 or multiple CAM methods for pain was 48.1%. The Social Functioning scores obtained from the SF-36 of the CAM users were statistically significant. For the participants who used a CAM method, the average Role-Emotional score obtained from the SF-36 was statistically significant. Health professionals should know which CAM methods patients may prefer and to what extent various CAM methods affect quality of life. More studies are needed to identify factors affecting the use of CAM methods in patients with RC attacks and to understand the relationship between CAM method(s) and quality of life.

The Possibilities of Complex Echography in the Diagnosis of Acute Appendicitis in Children

Acute appendicitis (OA) is currently the most common urgent disease of the abdominal cavity and occurs in 2-5 people per 1,000 populations. In the Republic of Uzbekistan, this indicator is 3.05 people per 1,000 populations according to the statistical materials on the activities of healthcare institutions of the Republic of Uzbekistan. Children with acute appendicitis were admitted to the hospital with complaints lasting up to 12 hours - 110 (46.6%), from 12 to 24 hours - 49 (20.8%), from 24 to 48 hours - 43 (18.2%) and from 48 hours or more - 34 (14.4%) children. In children with a disease duration of more than a day, only destructive forms of inflammation of the vermiform process were recorded. After 24 hours from the onset of clinical manifestations, children with phlegmonous and gangrenous appendicitis were admitted. Various variants of the location of the cecum and the vermiform process made it necessary to thoroughly examine the entire abdominal cavity. In 15 children, the diagnosis of OA was excluded due to the presence of other acute abdominal diseases. Thus, ovarian apoplexy was observed in 3 girls, pelvic pain syndrome caused by various gynecological diseases in 5 girls, acute pancreatitis with diffuse pains in 2, an attack of renal colic on the right in 5 children. Thus, the study of the features of the course of various clinical forms of acute appendicitis in children allowed to increase the effectiveness of diagnosis and improve the results of treatment. Ultrasound examination is a promising and safe method of diagnosing acute appendicitis, which allows to bring the effectiveness of complex diagnostics to 100% and is of important importance when choosing treatment tactics.

Use of Extracorporeal Physical Vibration Lithecbole Through Greater Sciatic Foramen for Treatment of Distal Ureteral Calculi.

Introduction: To evaluate the efficacy and safety of performing extracorporeal physical vibrational lithecbole (EPVL) through greater sciatic foramen (GSF) for distal ureteral calculi (DUC) treatment. Materials and Methods: All patients with a diagnosis of DUC (6-10 mm in diameter) were enrolled in this study from October 2018 to May 2020. Patients were randomly divided into three groups receiving EPVL through GSF (Group A, n = 58), or abdominal (Group B, n = 60), or combined with oral use of tamsulosin at 0.4 mg daily (Group C, n = 63). Results: There was no significant difference observed in terms of demographic characteristics or size of stones among the three groups (p > 0.05). Compared with the Groups B and C, patients of the Group A displayed a significantly higher score of comfort, with a significantly decreased number of renal colic attacks or analgesics required (p < 0.01). The stone-free rate also significantly increased after 1 and 2 weeks of treatment (p < 0.01), despite such a significant difference among these groups vanishing after 4 weeks of treatment. Conclusion: EPVL in the prone position uses the GSF as the path and is a safe and effective approach to treat the distal ureteral calculi.

EVALUATING THE EFFECTIVENESS OF PRIMARY ANALGESIC AND SUBSEQUENT COMBINED MET–THERAPY IN RENAL COLIC THERAPY

Renal colic is an acute pathological symptom complex, which, despite all the achievements of medicine, demonstrates constant occurrence rate of about 12% in the human population. This condition is characterized by a pronounced sudden pain attack, which causes significant suffering to the patient. Therefore, the search for effective and safe methods of analgesia and the search for ways to correct urinary obstruction as a cause of pain are of great clinical importance. The aim of the study was to assess the effectiveness of analgesic and combined lithoeradicative therapy to improve the management of patients with acute attack of renal colic. The clinical study included 228 individuals admitted to the hospital with a diagnosis of renal colic. At the first stage, they were divided into three groups to assess the effectiveness of the pharmacological management of primary analgesia. At the second stage, 96 patients were examined, and then divided into 2 subgroups in order to assess the effectiveness of medical expulsive therapy in its mono–variant and in combination with spasmolytics. The results obtained demonstrated that during the primary analgesic therapy of renal colic, non–steroidal anti–inflammatory drugs have advantages over the opioid group that is manifested by a stronger analgesic effect and less severe adverse reactions. Diclofenac showed the best results in pain relief, superior to other drugs by 5–7%. When evaluating the effectiveness of combined medical expulsive therapy, the data obtained indicate an increase in the chances of calculi passage by 11% in the group, which received drotaverine additionally to the therapeutic scheme, and, consequently, a decrease in the number of patients requiring further surgery. This group also demonstrated a pain reduction by 6–7%. Summarizing the data obtained, we can recommend the administration of diclofenac in a dose of 75 mg for primary analgesia of renal colic, and when conducting medical expulsive therapy, combine α–blockers and spasmolytics should be applied. This will lead to improved clinical results in patients with renal colic.

Comparison of the Effects of Four Treatment Techniques Commonly Used in Ureteral Stone Treatment on Patients' Daily Physical Functioning: An Observational Randomized-Controlled Study.

Objective: To investigate the effect of four different techniques used in the treatment of ureteral stones on patients' daily physical functioning (PF) and quality of life (QoL). Materials and Methods: Patients who underwent ureterorenoscopy (URS)-with or without Double-J stenting (DJS)-and extracorporeal shock wave lithotripsy (SWL) were divided into four groups: Group I: SWL (n = 29), Group II: URS (n = 43), Group III: URS +4.8F DJS (n = 39), Group IV: URS +6F DJS (n = 42), and Group V: Control (n = 30). Short Form-36 (SF-36) was administered to each participant both preoperatively and 14 days after operation. Based on the SF-36 results, the changes in patients' PF and QoL were evaluated. Results: Ureteral stone treatment was performed in 202 patients. Of these, 153 patients who underwent an effective SWL or URS procedure in the first attempt were included in the study. Success rates in the first session were 53.7% (29/54) and 83.8% (124/148) for SWL and URS, respectively (p < 0.001). All the four groups were similar with regard to age, gender, body mass index, stone size, preoperative PF, and QoL. However, although postoperative PF, role limitations due to physical health, and energy/fatigue scores were similar in Group I, III, and IV, they were significantly higher in Group II. No major complication associated with SWL or URS occurred in any patient. However, in Group 2, DJS was inserted in three (7.7%) patients in the early postoperative period (within the first 48 hours) due to renal colic attacks secondary to ureterovesical junction mucosal edema. Conclusion: URS without DJS seems to be the most advantageous technique in the treatment of ureteral stones in terms of daily PF and QoL. However, it should be noted that patients undergoing URS may require postoperative emergency stenting, although rarely.

Medical Expulsive Therapy Following Shock Wave Lithotripsy in Ureteral Calculi: An Effective Approach for the Improvement of Health-Related Quality of Life

Objective: To evaluate the possible effects of medical expulsive therapy (MET) on the health-related quality of life (HRQOL) of patients undergoing shock wave lithotripsy (SWL) for ureteric stones. Methods: Eighty patients treated with SWL for ureteric stones were included in this study. Patients were divided into 2 groups; Group 1 received medical therapy only for colic pain and Group 2 received MET in addition to medical therapy. Patients requiring DJ stenting and auxiliary measures after SWL procedure were excluded. The remaining 54 patients were further evaluated (Group 1: n = 26, Group 2: n = 28) and followed up during the 4-week period for analgesic requirement, number of renal colic attacks, emergency department (ED) visits and the HRQOL scores by using EQ-5D index and EQ-5D visual analogue scale (VAS) values. Results: During the 4-week follow-up period, cases undergoing SWL only required significantly higher amount of analgesics. In addition to the lower number of renal colic attacks and ED visits, EQ-5D index and EQ-5D VAS values also demonstrated higher mean values in patients undergoing SWL + MET. Conclusion: In addition to the increased spontaneous stone passage rates, MET following SWL for ureteral calculi could increase the HRQOL scores by lowering the number of both renal colic attacks and ED visits along with decreased analgesic need.

Effect of medical expulsive therapy on the health-related quality of life of patients with ureteral stones: a critical evaluation.

To evaluate the possible effects of medical expulsive therapy (MET) on the health-related quality of life (HRQOL) of the patients under watchful waiting for ureteral stones. A total 120 patients with ureteral stones were included into this study program. Patients were divided into two subgroups. While patients in group 1 received medical therapy only for colic pain if needed, patients in group 2 received MET (tamsulosin 0.4 mg/once daily) in addition to medical therapy. All cases were evaluated weekly during 1-month period, and the patients with persistent stones after this period in both groups were evaluated with respect to the analgesic requirement, number of renal colic attacks as well as emergency department (ED) visits along with the QOL scores. Mean values of patient age and stone burden were 37.14 ± 2.46 years and 42.04 ± 2.03 mm(2), respectively. Evaluation of the cases with residing stones after 4 weeks (28 cases in group 1 and 27 cases in group 2) with or without MET revealed following findings; renal colic, total amount of analgesic required and the mean number of ED visits were significantly lower in cases receiving MET. Evaluation of the mean HRQOL in terms of EQ-5D index and EQ-5D VAS values in both groups again demonstrated higher mean values in patients undergoing MET (p < 0.05). Our findings indicated that MET for ureteral calculi during watchful waiting period could increase the HRQOL scores by lowering the number of both renal colic attacks and ED visits resulting in decreased analgesic need.

Adjuvant alpha adrenergic blockers: Are they equally efficient for renal and upper ureteral calculi disintegrated by shock wave lithotripsy?

Abstract Objectives To evaluate the effects of tamsulosin on stone clearance and analgesic requirements after shock wave lithotripsy (SWL) for solitary renal and upper ureteral calculi. Patients and methods A prospective randomized placebo controlled study was carried out on 126 patients who underwent SWL for solitary radio-opaque renal or upper ureteral calculi ≤20 mm. Patients were randomized into two groups receiving either 0.4 mg of tamsulosin (GT) or placebo (GP). SWL was performed 3-weekly until patients became stone-free or for a maximum of 3 months. Analgesics were used on demand and pain was evaluated by a visual pain scale. Results Renal stones represented 55.6% and 66.7% for GT and GP, respectively ( p = 0.27). Mean renal and ureteral stone size were (12.3 ± 1.8 mm vs. 11.5 ± 2.3 mm, p = 0.14) and (9.7 ± 2.6 mm vs. 8.6 ± 1.7 mm, p = 0.1) for the GT and GP, respectively. GT required fewer SWL sessions for ureteral (1.2 vs. 1.6, p = 0.02) and renal stones (1.8 vs. 2.3, p = 0.08). Stone-free rate (SFR) was higher in GT for upper ureteral stones (96.4% vs. 66.7%, p = 0.01) and renal pelvis stones at a cutoff size >10 mm ( p = 0.01). The mean time of stone clearance was significantly lower in GT (4.2 ± 1.9 weeks vs. 7.5 ± 2.3 weeks, p = 0.001) for ureteral stones. Attacks of renal colic were more frequent in GP (82.5% vs. 44.4%, p = 0.04) with increased demand for analgesia ( p = 0.04). Steinstrasse was recorded in 3 and 7 patients of the GT and GP, respectively ( p = 0.32). Conclusion Tamsulosin facilitates clearance of upper ureteral stone fragments after SWL and decreases the analgesic requirements. These effects were not similarly evident for renal stones.

Routine Postoperative Imaging is Important After Ureteroscopic Stone Manipulation

Improved fiber optics and advanced intracorporeal lithotripsy devices have significantly decreased the incidence of complications during ureteroscopic procedures. Despite recent reports suggesting that radiographic imaging may not be necessary in all individuals after routine ureteroscopy silent obstruction may develop in some, ultimately resulting in renal damage. We determined the incidence of postoperative silent obstruction at our institution and assessed the need for routine functional radiographic studies after ureteroscopy. We retrospectively reviewed the charts of 320 patients who underwent a total of 459 ureteroscopic procedures for renal or ureteral calculi in a 3-year period. Complete followup with imaging was available for 241 patients (75%). Average patient age was 47.2 years. The variables of interest reviewed included preoperative pain, preoperative obstruction, targeted calculous site, stone-free rate, postoperative pain and postoperative obstruction. Mean followup was 5.4 months (range 2 to 43). A total of 241 patients with complete followup were identified in this analysis. Preoperative pain was present in 202 patients (84%) and 168 (70%) had preoperative obstruction. Overall targeted calculous clearance was successful in 73% of the patients and an additional 15.8% had residual fragments less than 4 mm. The renal, proximal or mid and distal ureteral stone-free rate was 32.1%, 81.9% and 90.5%, while in an additional 46.4%, 6.3% and 6.7% of cases, respectively, residual fragments were less than 4 mm. Of the 241 patients 30 (12.3%) had obstruction postoperatively due to residual stone in 25 (83.3%), stricture in 3 (10%), edema of the ureteral orifice in 1 (3.3%) and a retained encrusted stent in 1 (3.3%). Postoperatively obstruction correlated with postoperative pain in 23 of the 30 patients (76.7%). Pain was present postoperatively in 30 of the 211 patients (14%) without evidence of ureteral obstruction postoperatively. However, silent obstruction developed in 7 patients (23.3%) or 2.9% of the total cohort. All 7 patients underwent secondary ureteroscopy to alleviate obstruction. A single patient ultimately received chronic hemodialysis for renal failure, 1 was lost to followup and in 5 there was documented successful resolution of the cause of obstruction. Our analysis suggests that silent obstruction remains a potentially significant complication after stone management. Relying on postoperative pain to determine the necessity of postoperative imaging places patients at risk for progressive renal failure due to unrecognized obstruction. Therefore, we recommend that imaging of the collecting system should be performed by excretory urography, spiral computerized tomography or ultrasound within 3 months after routine ureteroscopic stone treatment to avoid the potential complications of unrecognized ureteral obstruction.

A Hospital-Based Survey of Primary Hyperparathyroidism in the Asir Region: Low Prevalence or Underdiagnosis?

The number of patients with primary hyperparathyroidism (PHP) seen at the Asir Central Hospital (ACH) is remarkably low. This observation has raised the question of whether there is a low prevalence of PHP in the Asir region, whether it is underdiagnosed, or perhaps a combination of both factors. A survey of 15 hospitals in the Asir region was conducted for cases of PHP. All case notes of the patients with PHP seen at ACH were reviewed. Also, a sample of patients seen at ACH was chosen randomly. The charts of those found to have hypercalcemia were reviewed for the inclusion of PHP in the diagnostic work-up. Only 13 patients with PHP were discovered. The eight patients with PHP seen at ACH had advanced bone manifestations and seven of them had renal manifestations. Hypercalcemia was found in 39 out of 655 patients seen at ACH. None of these had been investigated for PHP. The number of patients with PHP seen in hospitals in the Asir region is very low. Underdiagnosis seems to be an important factor. Therefore, it is felt that there is a need for greater awareness of the disease in the region. Furthermore, there is a need for a national survey to measure the prevalence of PHP in Saudi Arabia.

Acute Radiorenography During Attacks of Renal Colic

Acute radiorenography was compared to emergency excretory urography to evaluate its diagnostic accuracy in 22 patients with clinical signs of renal colic, including erythrocytes in the urinalysis. All 16 patients with delayed excretion and/or dilated renal pelves on excretory urography had delayed excretion of radioactivity on renography. Furthermore, 6 patients with reduced renal function judged by renography had marked or slight delay in excretion on excretory urography. Small stones not causing stasis were found on excretory urography in 2 patients with normal renograms. It is concluded that acute radiorenography is simple, rapid and safe, and identifies accurately patients with abnormal renal function during attacks of colic, with less risks than excretory urography of causing renal damage or aggravating the pain of renal colic.

Recessive X‐Linked Hyperuricemia with Gout and Renal Damage, Normal Activity of Hypoxanthine Phosphoribosyltransferase and Resistance to Azaguanine

A family is reported where four males have developed hyperuricemia, renal damage and, except for the youngest person affected, gout at an early age. The disease appears to be inherited as an X-linked recessive metabolic error. Clinically the patients have developed classical, tophaceous gout before the age of 25 and have suffered repeated attacks of renal colic. Renal tubular damage with decreased ability to concentrate and acidify urine was seen in a family member of only 16 years of age. Progressive renal failure seems to develop slowly. None in the family has shown neurologic symptoms, and two of the four affected men are apparently of at least average intelligence, two slightly below average. One female carrier has repeatedly passed uric acid stones. Studies of the red blood cell lysate have shown a normal activity of enzyme hypoxanthine phosphoribosyltransferase, and an increased level of adenine phosphoribosyltransferase. Skin fibroblasts from affected family members grew normally in the presence of 8-azaguanine. Administration of azathioprine to the patients did not decrease their serum uric acid levels. This is the first family described with this type of disorder of the purine metabolism.

Diuretic-Induced Renal Colic

To the Editor.— Two articles report 1,2 water- and beer-induced diuresis precipitating attacks of renal colic in patients with intermittent hydronephrosis. Here is an account of renal colic resulting from drug-induced diuresis. This response led to the discovery of previously asymptomatic partial urinary tract obstruction. Report of a Case.— A 43-year-old white woman with a uterine fibroid known since the age of 38, at an annual examination in 1972 complained of premenstrual edema with a weight gain of five pounds, tenderness of the breasts, and general body heaviness. No abdominal, back, or flank complaints appeared, nor had they on previous examinations dating back to 1960. Menstrual cycles were normal and not prolonged. A large irregular uterus extended into the right lower quadrant of the abdomen. A combination of 50 mg of triamterene (Dyrenium) and 25 mg of hydrochlorothiazide was prescribed every other morning beginning ten days before each period, as

FREQUENCY OF RENAL COLIC DUE TO RENAL STONE ASSOCIATED WITH CHANGE IN CLIMATE DURING DIFFERENT MONTHS OF THE YEAR

OBJECTIVE: To study the incidence of renal colic attacks due to renal stone and its relationship withclimate during different months of the year.MATERIAL AND MONTHS: This prospective study was conducted on patients with renal colicsecondary to stones, who were admitted in the Institute of Kidney Diseases Hayatabad Peshawar betweenOctober 2010 &amp; September 2013.RESULTS: This study included 980 patients, 765 (78.06%) were male and 215 (21.93%) were female.Themean age of the patients was ( 33.1± 9.8years). Majority of the patients 807(82.4%) were under 40 years ofage. Renal colic was more common in summer months like June 118 (12%), July 111 (11.3%) August 109(11.1%) and September 88 (9%) respectively. The lowest no of admission was in February 40 (4.1%),January43 (4.4%), and March 45 (4.6%). It shows that the mean admission of the year due to renal colicsecondary to stone was significantly different from mean admission of the warmer months 578 patients(59%) in comparison to winter month 402 patients (41%). It shows that there was 18% increased incidenceof renal colic visits in the warmer months of June, July and august compared with the colder months ofDecember,January and February.CONCLUSION: The renal colic visit was more in the summer and highest in the month of June, July,August and declining start from September onward and lowest in February. We found a strong positivecorrelation between ambient temperature and renal colic visits.

Peripelvic extravasation.

A report is presented on a patient in whom the intravenous urogram, obtained during an acute attack of renal colic due to an ureteral stone, disclosed peripelvic extravasation. Similar reports in the literature are relatively rare. It might be that such extravasation in acute obstruction can be more frequently observed when intravenous urography is done during the acute phase of the obstruction. This is suggested also by the observation of a slight degree of pericalyceal extravasation during compression in intravenous urography. This extravasation arises from small ruptures in the fornices and from this point continues via several possible pathways, viz.: the pyelolymphatic, pyelovenous, pyelointerstitial as well as the pericalyceal and peripelvic.

Ureteric calculus with unusual radiographic features.

The radiographs of the following patient are considered to be so unusual as to merit publication. Mrs. M. S., aged 37, gave a 12-year history of recurrent attacks of renal colic. She passed a stone in her urine three years ago. Seven weeks before an intravenous pyelogram (IVP) she had a severe attack of right renal colic.

URETERAL INJECTION OF OIL FOLLOWED BY THE SPONTANEOUS PASSING OF A URETERAL STONE.

Mrs. P., age 35 years, married 10 years. Family and previout history gives no information. Present sickness commenced in June, 1897, with a sudden colicky pain in the right iliac region and lancinating pains down the inner surface of the right thigh. This attack lasted 20 hours, and during this period Dr. Etheridge found a copious quantity of blood in the urine, and was obliged to give morphin hypodermatically to alleviate the pain. Since then the patient has had repeated typical attacks of renal colic; however, the pain was more or less localized in the right iliac region, and the attacks were never as severe as the first. A skiagraph taken in December, 1902, showed the outlines of a ureteral stone. The dull ache and tenderness always corresponded to this point. Drs. Harvey and Paddock referred the case to me Jan. 5, 1904. I catheterized the right ureter and several

A CASE OF STONE IN THE KIDNEY—NEPHROLITHOTOMY—RECOVERY.

Since Dr. Morris, of Middlesex Hospital, elaborated the operation for the removal of a stone from the kidney, the procedure has been frequently and successfully employed. The diagnosis of that condition is often difficult. In a sweeping way it might be stated that the inconstancy of the symptoms has prevented precision in the recognition and location of the disease. Again, other pathologic renal affections have shown symptoms suggestive of stone in that organ. Repeated attacks of renal colic, blood and pus in the urine, with the occasional passage of sabulous matter per urethram are strongly suggestive of it. Jordan Lloyd's valuable test led the writer to the diagnosis of stone in the kidney in the case about to be narrated. The hypothesis of renal calculus was offered, however, with mental reservations; for one surgeon, Dr. Jacobson, of Guy's, has reported not less than twenty-five exploratory lumbar incisions, where the symptoms